Orthoptics: area of practice

Orthoptists are responsible for the diagnosis and treatment of people with eye difficulties.

Orthoptists are responsible for the diagnosis and treatment of squint and abnormal eye movements. Their role involves checking that patients have the best possible vision in each eye, as well as good 3D vision when they use their eyes together as a pair. The majority of an orthoptist’s work will be with the young who could have a lazy eye and need to wear a patch, for example, or with the old who could have difficulty controlling their eye movements.

At the diagnosis stage, orthoptists work very closely with ophthalmologists, who specialise in the medical and surgical management of eye conditions, to plan any treatment that might involve surgery. They will also work with the wider healthcare team, including doctors and optometrists who perform eyesight tests and prescribe corrective lenses. Once an assessment has been made, measurements will be taken and a treatment plan formed for the patient, which could involve eye exercises or the addition of prisms to a patient’s glasses to control double vision.

Most orthoptists are hospital-based so patients will be referred to them by healthcare staff or GPs. However, some orthoptists do work in the community – for example, visiting primary schools to conduct vision tests to assess whether children have any difficulties with their vision that will need to be treated.

Starting out

‘Orthoptist’ is a protected title, which means that you must be registered with the Health and Care Professions Council (HCPC) in order to practise. You can only register with the HCPC if you have studied for an HCPC-approved orthoptics degree course. This is a three-year full-time degree course. You can also join the professional and educational body for orthoptists, the British and Irish Orthoptic Society (BIOS). 

For those starting out, the good news is that there is no shortage of vacancies available, though you may need to move. Most positions are within the NHS; however, there are also opportunities for work in private hospitals and clinics, special schools, charities and the armed forces. Graduates are qualified to see patients on their own immediately after graduation, but most will join an orthoptics department where they will be supervised by a more senior member of staff. They will also have a mentor who can be approached for guidance or for advice about how to treat particular cases.

Career progression can be through specialisation, so orthoptists could choose to specialise in working:

  • with children
  • with older children who have reading difficulties
  • with stroke patients
  • with glaucoma patients

Orthoptists can also go into teaching and management positions.

Skills required

Orthoptists need to be able to communicate well with people of all ages and backgrounds as most of their time will be spent dealing with patients face to face. They need to be methodical, accurate and enjoy taking measurements, and be able work in a pressurised environment in order to meet NHS targets.

Orthoptists should be able to motivate themselves to work on their own but should also be able to work well as part of a team – something which is vital to patient care. Finally, orthoptists need to have good eye sight, be dextrous and be able to manipulate the instruments they’ll be using to diagnose conditions.